Rebecca Walthall Riles, OT-A

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA681 Issued in AR

Practice address

316 Main Street
Lake Village, AR 71653

Phone

(870) 265-3950

Fax

(870) 265-2525

NPI assigned

Apr 26, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Occupational Therapy Services Inc.

  dba KidSense Therapy Clinic

  • Pediatric Occupational Therapist
  • Lake Village, AR
  • NPI 1942314893
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1303776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1619268679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 MAIN STREET",
            "city": "LAKE VILLAGE",
            "state": "AR",
            "postal_code": "71653",
            "telephone_number": "870-265-3950",
            "fax_number": "870-265-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 MAIN STREET",
            "city": "LAKE VILLAGE",
            "state": "AR",
            "postal_code": "71653",
            "telephone_number": "870-265-3950",
            "fax_number": "870-265-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILES",
        "first_name": "REBECCA",
        "middle_name": "WALTHALL",
        "credential": "OT-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-26",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "AR",
            "license": "O-T1103",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AR",
            "license": "OTA681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186149721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leatrice Powell
• RCG of Lake Village, LLC (RCG Lake Village)
• Natlie R Reed, LICENSED CERTIFIED S
• Sherri Chanel Reggans
• Clara Jane Rice, PHARMD
• Robinson Eyecare Clinic
• Mark Stephen Robinson, OD
• Syrina Robinson
• Alice Mae Rogers-Johnson, RNP
• Samantha Rogers

• Occupational Therapy Assistant in Lake Village, AR
• Providers in Lake Village, AR by specialty
• Occupational Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.